Organization Active NPI

The Doctors Medical Clinic, P.a.

  • Multi-Specialty Clinic/Center
  • Saint Paul, MN
National Provider Identifier
1114247061
Registry record updated Jun 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
THE DOCTORS MEDICAL CLINIC, P.A.
Practice address
217 Como Ave
Suite 105
Saint Paul, MN 55103-1838
Phone
(651) 771-2513
NPI assigned
Jun 2, 2010
Last updated
Jun 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Nancy Moua
Title
Manager
Phone
(651) 771-2513

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

217 Como Ave
Suite 105
Saint Paul, MN 55103-1838

Mailing address

1504 White Bear Ave N
Suite a
Saint Paul, MN 55106-1622

National Provider Directory

National Provider Directory

Locations

217 Como Ave
Ste 105
Saint Paul, MN 55103
Phone (651) 771-2513

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275436800000",
    "number": "1114247061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 WHITE BEAR AVE N",
            "address_2": "SUITE A",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551061622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 COMO AVE",
            "address_2": "SUITE 105",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551031838",
            "telephone_number": "651-771-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DOCTORS MEDICAL CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-02",
        "last_updated": "2010-06-02",
        "status": "A",
        "authorized_official_last_name": "MOUA",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "651-771-2513"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.